News in brief - March 3, 2003

HIPAA security rule finalized - Inadequate access for poor children - Settlement in Cardizem lawsuit

HIPAA security rule finalized

Long-awaited security standards for individually identifiable health information have been finalized by the U.S. Dept. of Health and Human Services. The rule requires doctors to apply administrative, physical and technical safeguards to their electronic records to protect patient information. Physicians' offices will have to be in compliance with the rule by April 21, 2005.

HHS also adopted modifications to the national standards for electronic transactions and code sets.

"Overall, these national standards ... will make it easier and less costly for the health care industry to process health claims and handle other transactions while assuring patients that their information will remain secure and confidential," said HHS Secretary Tommy Thompson.

Information on the security rule and the transaction standards is available at the HHS Web site (http://www.cms.hhs.gov).

Inadequate access for poor children

A new report from the General Accounting Office concludes that states do little to ensure physician access for children enrolled in Medicaid or the State Children's Health Insurance Program.

For children enrolled in managed care plans through Medicaid or SCHIP, few states put much effort into verifying that plans were meeting requirements for adequate physician networks. Information collected by states on access was often incomplete and unreliable, according to the GAO.

The report also found that most states failed to monitor physician availability for children in Medicaid fee-for-service programs, despite the readily available data contained within claims payment systems.

Settlement in Cardizem lawsuit

Fifty states will share in an $80 million settlement from the makers of the heart medication Cardizem CD and its generic equivalent, which state attorneys general accused of violating antitrust laws.

The states accused Aventis Pharmaceuticals Inc. of paying Andrx Corp. and its affiliated entities nearly $90 million to keep a less expensive generic version of Cardizem off the market. Once a generic was eventually made available, it cost more than it should have, the attorneys general said. The states alleged that the drug makers' deal forced patients and health programs, such as Medicaid, to pay higher prices than necessary.

The settlement will apply to anyone who purchased Cardizem CD or its generic equivalent between January 1998 and January 2003.